Aging And Disease
What are the most common diseases we get as we age?
The most common disease probably associated with aging is arthritis. The majority of people over age 65 have some degree of osteoarthritis. Many people manifest symptoms by pain or discomfort, etc. As we get into the 70s and 80s, then dementia becomes more common. When you get to be 85, about 30 to 40 percent of Americans have dementia. Parkinson's disease becomes more common with aging. Diabetes, adult onset diabetes, when you get to be about 65 you're about a one in four risk of having it. Hypertension, you have about a 40 percent chance of having hypertension as you reach age 65.
Are there diseases caused by aging itself?
There's normal aging which are the normal changes with aging, and superposed upon that are diseases that become more frequent with aging. Why geriatric is so important is it distinguishes the normal changes with aging from the diseases. For example, if you come in with an eye problem, a normal doctor may say that it doesn't sound like much of an issue, it might be just a normal aging. But the geriatrician might say lets test the pressuring on your eye. Maybe you have coloboma which does become more frequent with aging. Or maybe is a cataract, which they can do something about. So I think the critical issue for geriatrics is distinguishing normal aging issues from disease.
What are the most common causes of death in the elderly?
The older you get, the more likely you're going to die of a heart attack or a heart problem. So that your risk at age 65 is probably around 60%, but by age 80 it's about 80%, and by 90 it's probably about 90%.
What are the most common physiological changes caused by aging?
The most common physiological changes with aging, starting from the top of your head, is getting gray and loss of hair. In your eye, the amount of light coming in your eye decreases, so it's harder to detect colours and you may need reading glasses. With your nose, you can have problems with smell. Concerning your ears, you have decreased hearing. With taste, you lose your taste ability with aging. Your joints become stiffer, your skin changes and becomes less flexible. Your heart can't beat as rapidly and your lungs don't expand and contract as efficiently. Your kidneys don't secrete urine as well as they used to either. And that's just the short part of the long laundry list I could give you about physiological changes with aging.
What is 'presbyopia'?
Presbyopia is farsightedness, but it's really a hard definition. A better way of looking at it is your need for reading glasses. Almost everyone at age forty to fifty develops the need to read further and further away, to the point where they can't even read the small print and need reading glasses.
What is 'end-stage renal disease'?
End-stage renal disease is a result of a number of conditions, which will reduce the ability of your kidney to secrete urine effectively. And in that point, you need either kidney transplant or you need dialysis.
What are the most common infectious diseases associated with aging?
The most common conditions to be concerned about as you get older are pneumonia, influenza, and urinary tract infections.
How can I prevent pneumonia?
We have now have a pneumo-vacs, which is a vaccine which has 8 or 10 different strains of pneumonia bacteria. We inject this into people, and give people vaccinations, about once every 10 years. This will prevent the most serious types of pneumonia that effect older people.
How dangerous is influenza to older people?
Influenza is a serious threat to an older person. It is a devastating condition, and regardless of how healthy you are, an older person is much more inclined to get sick and even die from influenza than a young person. It's a serious threat to older people.
How can I prevent influenza?
Influenza can be prevented by a vaccine; a yearly vaccine. Now the problem is that influenza strings change, and so your vaccine is different from year to year. And we all worry about the agent flu vaccine, because that's a very, very virulent or dangerous type of organism, and we don't have an effective vaccine yet for it. Neither would we give people that vaccine even if we had it because it hasn't broken out yet. So we have to want a vaccine against the agent flu and then, if it came to give it to people; and then, even then we don't know if it will be successful or not. So, flu is a big concern, both for the young and old people, but much more for old people. And we have to have a yearly vaccine for flu so that we can be prepared for it.
How does influenza cause death?
What happens is flu, or influenza, is a virus. It attacks your lung tissue and causes damage, but it doesn't usually kill you. What kills you is the bacterial pneumonia that comes on afterwards, and then causes the problems that result in death. So when you have influenza, or you get influenza, you need to be treated rapidly for the influenza, but also for the bacterial infection that occurs afterward.
Can influenza be cured?
If you have an early stage of influenza it can be treated now. We have anti viral drugs that we can give you that will slow down the development and reduce the symptoms and protect you from dying from influenza. You'll still get the disease, but it'll be much milder. Tamaflu, is the most common drug that's now used to treat influenza.
What is 'cardiovascular disease'?
Cardiovascular disease, translated, means the following: "cardio" is your heart, and "vascular" is your blood vessels. The primary cause is atherosclerosis. It's a disease of Western society. If you look at the aborigines in New Guinea, they don't get it very much. However, we do because of our diet. It is the main cause of death in this country. It causes heart attacks, it causes high blood pressure, it causes strokes, it causes peripheral vascular disease, and it causes clots in your blood vessels. It even contributes to dementia, and probably contributes to macular degeneration of your eyes. It's a disease that we need to treat aggressively.
What is a 'heart attack'?
A heart attack occurs when one of the small blood vessels that supplies blood to the heart called the 'coronary artery' becomes stuffed up or clogged, so that blood can't flow through it. The heart is not getting that blood, and therefore that part of the heart is going to die and that is called 'myocardial infarction'. Well, myocardial infarction is the technical word for heart attack. So the death of part of the heart causes the problems.
What are the warning signs of a heart attack?
Warning signs for a heart attack is when you start getting chest pains, or pains that radiates towards your jaw and down to your left arm that go away. Those are like warning signs that your blood vessels are constricting but they're not closing. They're keep having a spasm and they're not closing. And you should immediately go to your doctor and tell them about this and get worked up and make sure that you really are doing the right things to prevent a heart attack.
What is a 'stroke'?
A stroke is when one of the blood vessels that goes up into your brain gets stopped, either by a blood clot, some fat or a combination of the two and blood can no longer reach a part of your brain. Those brain cells will then start dying, and then part of your brain is dead and that is the stroke.
What are the warning signs for a stroke?
The warning signs for a stroke are when you get what is called a "TIA", a "transient ischemic attack". What that is, is you get stroke-like symptoms that go away. You have problems with speech. You have real paralysis of your face that goes away, comes and goes. That's sort of saying to you, "Hey, we have a blood vessel to your brain that's spasming, that's about to clot. It's in trouble." Go see your doctor. Go get worked up. Find out a way to prevent it.
What is 'type 2 diabetes'?
There are two types of diabetes. Type 1 is juvenile, young-onset diabetes, when you get a virus and it attacks your pancreas. It modifies the cells, your body looks at these cells now and sees that these cells are different. Your body attacks the cells in your pancreas and destroys the cells that make insulin. You don't have any insulin anymore. You have diabetes, and we have to give you insulin by injection or from the outside, from the environment, because you're not making it internally anymore. In Type 2 diabetes, usually caused by not exercising or not eating right, or being too heavy, your body's not metabolizing sugar as well. Your insulin is fine. Your body's not responding to it properly, and your blood sugar level rises, and you have diabetes.
What is 'cancer'?
Cancer is when the cells in your body divide abnormally. You may have a cell that doesn't usually divide, and it starts dividing rapidly. It now becomes a tumor, and the tumor can metastasise to your body and cause damage and eventually death. There are other cells in your body that normally do divide, but with cancer they divide abnormally, and in an unregulated way, and develop cancer or cell coma or lymphoma or leukaemia. These are all forms of cancer, which can then go throughout your body and cause you serious damage, and of course death.
Why is cancer more likely among the elderly?
We believe that cancer takes an amount of time to develop. So, for example, if you're exposed to a carcinogen, something that causes cancer like cigarettes, when you smoke a cigarette you don't get the cancer the next week. But after 10 years of smoking or 20 years of smoking, 10 years after that, 20 years after that, then you develop the cancers. So you have this latent period of time before you develop the cancer and that's why cancers are more common in later life.
Is cancer more common among the elderly?
What is 'osteoporosis'?
With age, we all lose bone density. When we lose a lot of bone density, we call it osteopinea. When it becomes even more serious, we call it osteoporosis. How do we determine this? We do a bone mineral density examination, and when we move below the average by a certain amount, one and half standard deviations, we call it osteopinea. When we move two and a half standard deviations below this average or mean, we call it osteoporosis.
Why is osteoporosis more common in women?
Osteoporosis is more common in women, because women start off with a smaller bone mass. It's much more common in women who are born from northern European stock, because their bone mass is even smaller. The stronger your bones and the bigger your bones are, the less chance you have of having osteoporosis and a fracture.
What is 'arthritis'?
Arthritis is inflammation of a joint. It can be caused by a whole area of different things, but the term arthritis means inflammation of a joint.
What causes arthritis?
There are many causes of arthritis. The most common is osteoarthritis, which is a wear and tear disease. Over time, after usage for years and years, the cartilage which separates your bones starts to deteriorate, and that starts the process which leads to osteoarthritis. You can accelerate it by trauma. You play football, you have a serious injury to your knee, that knee is much more likely to develop osteoarthritis much much earlier.
What is 'rheumatoid arthritis'?
Rheumatoid arthritis is a much more serious type of arthritis. It is, in fact, the body's reaction to your components of your joints, so it's an autoimmune disease. It affects your joints, it also affects your whole body. It's a bodily disease, it affects many organs besides the joints. It causes big, thick, red, swollen joints. It's devastating to people who have it. The good news is we have new and effective treatments for rheumatoid arthritis, so if you develop it, you need to see your physician as soon as possible.
What is 'sepsis'?
One devastating condition for older individuals is sepsis. Sepsis is the infection of your blood by a bacteria or a virus. This is a common cause of death in older people because their immune system is somewhat decreased as a function of aging. It can occur from pneumonia, a urinary tract infection or from a variety of infections in your body.
